title: The biophysical properties of the aorta are altered following Kawasaki disease.
abstract: BACKGROUND
  The long-term sequelae of Kawasaki disease (KD) are based on the coronary complications. Because KD causes generalized vasculitis, with documented aneurysms in the femoral, iliac, renal, axillary, and brachial arteries, the aim of this study was to assess the biophysical properties of the aorta (BPA) after KD. The BPA are biometric measurements representing vascular structural and dynamic changes in response to cardiac work.
  
  
  METHODS
  Anthropometric and echocardiographic measurements of the aorta in a series of patients with KD were compared with those of healthy subjects. The BPA were calculated noninvasively by extrapolating previously validated equations that were conceived for invasive measurements. Because BPA vary with body habitus, control subjects were used to normalize BPA parameters for height to compute BPA Z-score equations.
  
  
  RESULTS
  Between June 2007 and February 2010, BPA were recorded in 57 patients with KD >1 year after the onset of the disease, 45 without and 12 with coronary artery sequelae. The mean intervals between the acute onset of KD and enrollment were 10.0 ± 5.0 and 5.8 ± 4.5 years for patients with and without coronary artery sequelae, respectively (P = .008). Patients with KD with coronary artery sequelae had significantly altered Z scores of aortic diameter modulation, Peterson's elastic modulus, and β stiffness index (P = .001-.016). Patients with KD without coronary artery sequelae also exhibited altered elasticity, stiffness, and pulse-wave velocity (P = .001-.026).
  
  
  CONCLUSIONS
  Altered BPA after KD are detectible despite apparent resolution of acute vasculitis. Future directions toward determining multilevel and multilayer vascular impact, including vascular autonomous homeostasis, require thorough investigation.
authors.affiliation: Division of Pediatric Cardiology, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Laurence
authors.initials: L
authors.lastname: Vaujois
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dallaire
authors.forename: Roch L
authors.initials: RL
authors.lastname: Maurice
authors.forename: Anne
authors.initials: A
authors.lastname: Fournier
authors.forename: Christine
authors.initials: C
authors.lastname: Houde
authors.forename: Johanne
authors.initials: J
authors.lastname: Thérien
authors.forename: Daniel
authors.initials: D
authors.lastname: Cartwright
authors.forename: Nagib
authors.initials: N
authors.lastname: Dahdah
mesh_terms: D000222:Adaptation, Physiological; D001011:Aorta / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002675:Child, Preschool; D003198:Computer Simulation; D055119:Elastic Modulus; D005260:Female; D006244:Hardness; D006801:Humans; D008297:Male; D008955:Models, Cardiovascular; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D063177:Pulse Wave Analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013718:Tensile Strength; D014463:Ultrasonography; D014655:Vascular Resistance
keywords: ADM; Aortic diameter modulation; Aortitis; BPA; Biophysical properties of the aorta; CA; Coronary artery; Coronary artery sequelae; Elastic modulus; Ep; KD; Kawasaki disease; Mucocutaneous lymph node syndrome; No coronary artery involvement; PWV; Pulse-wave velocity; Sequelae; Systemic vasculitis; nCA; sCA